An outbreak of Candida parapsilosis prosthetic valve endocarditis following cardiac surgery

Five of 34 (15%) patients who received prosthetic cardiac valves between May and August 1982 at the Victoria General Hospital in Halifax, Nova Scotia, developed Candida parapsilosis prosthetic valve endocarditis. The clustering of these cases pointed to a common source outbreak. In a retrospective cohort study, no significant differences were found between infected and uninfected patients in terms of pre-, intra-, and postoperative risk factors. Environmental investigations suggested intraoperative contamination through the cardiac bypass equipment as the source of infection but a causal relationship could not be established. The outcome for the cases was uniformly fatal, emphasizing the need for prevention of such serious nosocomial infections.